Gene Expression Profiling in Uveal Melanoma: Five-Year Prospective Outcomes and Meta-Analysis.

Area of Science:

• Ophthalmology
• Oncology
• Genomics

Background:

• The 15-gene expression profile (15-GEP) test aids in predicting metastatic risk for uveal melanoma (UM) based on primary tumor biology.
• This study reports outcomes from a prospective registry and meta-analysis of 15-GEP-tested UM patients.

Purpose of the Study:

• To evaluate patient management strategies and 5-year clinical outcomes following 15-GEP testing in uveal melanoma.

Main Methods:

• Prospective enrollment of 89 UM patients with 15-GEP results across four centers.
• Collection of physician-recommended management plans and 6-month clinical outcome tracking.
• Meta-analysis with published cohorts to assess metastatic risk and survival rates.

Main Results:

• Eighty percent of Class 1 (low-risk) patients received low-intensity management; all Class 2 (high-risk) patients received high-intensity management (p < 0.0001).
• Five-year metastasis-free survival rates were 90% for Class 1 and 41% for Class 2 (p < 0.0001).
• Class 2 was the sole independent predictor of metastasis, significantly increasing metastasis and mortality risk.

Conclusions:

• 15-GEP testing effectively guides UM patient management, differentiating risk levels.
• Class 2 patients, with >50% metastatic rates, were appropriately managed more intensely.
• Class 1 patients were safely spared intensive surveillance, optimizing healthcare resource utilization.